Increasing ethnic diversity of the U.S. population requires health professionals to practice with greater cultural competence in areas such as the management of menopausal symptoms, where cultural beliefs mediate the biology of reproduction and aging. A growing number of studies have challenged the universality of menopausal symptoms by indicating significant ethnic differences in how women experience them. However, few investigators have studied ethnic populations in the U.S., and few studies have been national in scope. With advances in computer technologies, the Internet now provides an excellent medium of national and international communication and allows people in different geographical areas to communicate and exchange their experiences and opinions. The proposed study uses innovative Internet data collection methods to collect national data and essential information about specific ethnic differences in menopausal symptom experience while respecting women's own experiences. The specific aims are to: a) explore ethnic differences in menopausal symptom experience reported by 4 of the most common ethnic groups of women across the U.S. (Hispanic, non-Hispanic (N-H) White, N-H African American, and N-H Asian); and b) explore the ethnic-specific contexts of women's daily lives that influence women's self-reported menopausal symptom experience. A feminist approach will guide the research process. Innovative data collection methods will be used, including an Internet survey among 500 middle-aged women recruited using the quota sampling method with multiple recruitment strategies through various Internet settings, and online forums of 6-month duration among 4 different ethnic groups (30 members per group) recruited from among the Internet survey participants. Long-term goals are to: a) contribute to recognition of women's own menopausal symptom experience so that health care can be planned and provided from women's own views and perspectives; b) develop decision support systems for menopausal symptom management that can be validated across diverse practice settings; and c) eliminate ethnic biases and inequity in menopausal symptom management and promote culturally competent care for menopausal women.